Indigenous status completeness in notification data strong for some vaccine preventable diseases, but improvements needed

An NCIRS evaluation has found that recording of Aboriginal and Torres Strait Islander status in the National Notifiable Diseases Surveillance System (NNDSS) was more than 95% complete at the national level for some vaccine preventable diseases (VPDs).

The evaluation found, however, that Indigenous status completeness – that is, identification of Aboriginal and Torres Strait Islander status – was low for influenza (37.4%), pertussis (59.2%) and rotavirus (69.7%) notifications.

The NCIRS report provides a comprehensive evaluation of factors influencing the quality and completeness of Indigenous status for VPDs in the NNDSS.

There is a disproportionately higher burden of most VPDs in Aboriginal and Torres Strait Islander peoples. Additional vaccines are funded under the National Immunisation Program for Indigenous people. 

Associate Professor Frank Beard, Associate Director, Surveillance, Coverage, Evaluation and Social Science at NCIRS, said:

High-quality Indigenous status data in the NNDSS allow better evaluation of existing immunisation programs and consideration of new or expanded program initiatives. 

The main barriers to Indigenous status completeness were found to be: 
•    the absence of an Indigenous status field in most pathology request forms, leading to missing status identification in laboratory notifications
•    limited public health authority resource capacity to follow up missing data, particularly for high-incidence diseases.

These factors likely explain the low overall Indigenous status completeness for influenza, rotavirus and pertussis, all of which are high-incidence diseases that are predominantly notified by laboratories only.

However, completeness was high for these VPDs in the Northern Territory and Western Australia. This is largely attributable to routine public health follow-up of all notifications and/or manual cross-checking of hospital databases where Indigenous status is missing – resource-intensive activities that may not be feasible in all jurisdictions.

Associate Professor Beard said:

Accurate identification of Indigenous status at the point of service – whether GP, hospital or laboratory – should be the ultimate goal, along with accurate transmission of Indigenous status data between services and to public health authorities through the notification process. 

A nationally coordinated and consistent approach, developed in collaboration with jurisdictions, would be preferable, given many pathology services operate across jurisdictional borders.

Importantly, the development, implementation and evaluation of initiatives to improve Indigenous status completeness should be led by Aboriginal and Torres Strait Islander peoples wherever possible.

Read the full report: Evaluation of Indigenous status completeness in vaccine preventable disease notification data in the NNDSS

About NCIRS: The National Centre for Immunisation Research and Surveillance (NCIRS) is the leading research organisation in Australia working to support evidence-based policy development for the evaluation of the National Immunisation Program and surveillance of vaccine preventable diseases, vaccine coverage and vaccine safety. This work is funded through agreements with the Australian Government Department of Health and Aged Care. For more information, visit ncirs.org.au.